JMIR Publications

ABSTRACT

Background:

The COVID-19 pandemic resulted in a dramatic and rapid shift away from physical visits, resulting in an instantaneous and unplanned adoption of virtual (phone and video) visits.

Objective:

Administrative data at a large urban Canadian university-affiliated hospital network was analyzed to understand how clinical disciplines adopted phone and video visits early in the pandemic and how their use of virtual visits grew, sustained or was abandoned through the pandemic.

Methods:

Virtual visit adoption by clinical discipline was compared during both the early pandemic (Apr-May 2020) and peak reopening time periods (Oct-Nov 2020) in an attempt to categorize clinical disciplines by their adoption of virtual visits, and thus understand how best to provide change management support.

Results:

At our largest academic site, for which we had full data, 50.8% of ambulatory visits were provided by phone or video during the pandemic (94.5% phone, 5.5% video). There was considerable variability across services in terms of how they adopted virtual visits in the early pandemic and peak reopening. Phone was the dominant modality, but video had high usage (up to 95% of virtual visits) in select disciplines.

Conclusions:

We identified 4 patterns that provide opportunities for dedicated support in some disciplines: early sustained adoption, non-adoption, late growth, and late abandonment. The phone was the dominant modality (>90% of virtual visits) but video had high use in some disciplines necessitating targeted support. Additional high-quality research examining phone vs. video visits across disciplines and contexts is critical; until then both should be supported.